Health Screening by Tracy Kraus|Published July 6, 2020 Please fill out all sections of this Health Screening . This will help us keep your child and all of our campers safe. If you have questions, please contact Ariana Falk, ChamberFest Director at Ariana@worcesterchambermusic.org Thank you! Student Name Your Name Email Phone (no dashes) Has your child experienced any of the following symptoms in the past 24 hours? If you are an adult attending our program, please respond. Fever or chills Cough Shortness of breath or difficulty breathing Fatigue Muscle or body aches Headache Loss of taste or smell Sore throat Congestion or runny nose Diarrhea My child/me has not experienced any symptoms Has anyone in your household experienced any of the symptoms listed on the previous screen within the last 24 hours? Yes No Has your child been exposed to anyone displaying symptoms of COVID-19 in the pasts 24 hours? If you are an adult attending our program, please respond. Yes No Has anyone in your household been exposed to anyone displaying symptoms of COVID-19 in the last 24 hours? Yes No Additional Information: Thank you for your cooperation as we do our best to ensure the safety of everyone involved with ChamberFest! Time is Up!